两种不同人工晶状体在高度近视患者白内障手术中的应用观察

Clinical effects of different intraocular lens implanted in cataract eyes with high myopia

关键词:  高度近视  白内障  超声乳化  人工晶状体

Key words:  [Key words]　high myopia  cataract  phacoemulsification  IOL

摘要:

[摘要]　目的　探讨Bigbag及Rayner 620H两种不同人工晶状体在白内障合并高度近视眼内的有效性、安全性、稳定性。　方法　所有患者均自愿接受白内障超声乳化吸除联合人工晶状体植入术，研究组（A组）患者共22例（30只眼）选择Bigbag人工晶状体，对照组（B组）选择Rayner620H人工晶状体共20例（30只眼）。术后随访3个月。分别于术前、术后1周、术后1个月及术后3个月时观察患者眼轴、视网膜黄斑部中心凹厚度、后囊膜皱褶和后发障发生率。采用SPSS19.0统计学软件进行数据分析。　结果　（1）眼科专用A超测量术前及术后两组眼轴长度，两组术后各时期与术前比较差异无显著性意义（P>0.05）；（2）两组患者术眼均行OCT检查，A组患者各时期视网膜黄斑区中心凹厚度与术前比较差异无显著性意义（P>0.05），B组患者各时期黄斑区中心凹视网膜厚度与术前比较差异有显著性意义（P<0.05），即黄斑区中心凹视网膜厚度明显增加；（3）术后3个月内观察A、B两组患者后囊膜皱褶，A组患者均未见后囊膜皱褶，B组共5只眼出现后囊膜皱褶，两组比较差异有显著性意义（P<0.05）；（4）术后3个月内后发障，A、B两组患者之间比较的差异无显著性意义（P>0.05）。　结论　Bigbag人工晶状体较稳定，Bigbag人工晶状体较Rayner 620H人工晶状体更适合于高度近视性白内障患者。

Abstract:

[Abstract] Objective　To investigate the safety and effects of Bigbag Intraocular Lens （IOL）and Rayner 620H IOL in cataract eyes with high myopia and to discusse the stability of these two IOLs within the eyes. 〖WTHZ〗Methods〖WTBZ〗 Totally, 60 cataract eyes with high myopia out of 42 patients, who were admitted from January 2012 to June 2013, were selected in this study. 30 eyes were in group A using Bigbag IOL, and 30 eyes were in group B using Rayner 620H IOL. All the eyes in both groups underwent phacoemulsification with IOL implantation surgery by the same ophthalmic surgeon, and there were no complications like posterior capsular rupture. In this research, the patients were assessed by axial length (AL), post-operative posterior capsule cataract, posterior capsule wrinkle and thickness of fovea (Optical Coherent Tomography). The assessments were done at regular intervals: preoperative stage and postoperative at one day, one week, one month and three months. All data were processed by using the SPSSS 19.0 software for comparison of results within each group and between the two groups. 〖WTHZ〗Results　（1）As for the AL measured before and after operation, there were no significant differences in both group A and group B (P>0.05). （2）OCT examination demonstrated that the foveal thickness of group A increased after operation at each stage, but there were no significant difference when compared with before operation (P>0.05). In group 〖CM（48*2〗B, the foveal thickness at all stages increased when compared to preoperative data, and it showed significant difference (P<0.05). （3）At 3 months post surgery, there were no posterior capsular wrinkle in any of the eyes in group A, while posterior capsular wrinkle was observed in 5 eyes in group B, but there was no significant difference between the two groups (P>0.05). （4）There were no significant difference of the postoperative posterior capsule cataract rate in group A and group B (P>0.05). 〖WTHZ〗Conclusion〖WTBZ〗 Postoperatively, Bigbag IOL is more stable and has lower incidence of macular edema, and thus more suitable for cataract patients with high myopia.